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P118 Effects of epilepsy and valproic acid on oxidant status in children with idiopathic epilepsy
Posters long-term low dose maintenance therapy to avoid relapses in the long-term follow-up. Epileptiform EEGs have been normalised in 1 case and have decreased in 4 cases. Speech disorders have disappeared in 2 and have softened in 3 children. Behaviour disorders have been cured in 3/4 cases, and softened in 1 case. Seizures have disappeared in all cases. 1 child is totally asymptomatic, 4 of them lives with softened symptoms. Analysing our data, we found that the earlier the therapy starts, the more effective it is. On the basis of our data, ACTH is an effective treatment for Landau Kleffner syndrome. After giving it for just a short period, relapses often occur, so adjustment of long term low dose maintenance therapy is advisable in order to avoid relapses. P117 General or specific language impairment? Electrophysiological and neuropsychological study of Landau Kleffner syndrome 1 R. Kalm *, L. Szabo´ 1 , F. Honbolygo´ 2 , V. Csepe ´ anchey ´ ´ 2 . 1 2nd Department of Pediatrics, Semmelweis University, Budapest; 2 Research Institute for Psychology of the Hungarian Academy of Sciences, Budapest
Our study aimed to investigate the neurocognitive correlates of Landau Kleffner Syndrome (LKS). Six children suffering from LKS, and eight children with Benign Childhood Epilepsy with Centro-Temporal Spikes (BECTS) as clinical control have been studied. Neuropsychological assessment (NEPSY® ) providing comparable scores in five domains (language, attention and executive functions, sensorimotor function, memory and learning, visuospatial processing) as well as event-related brain potential (ERP) measures were performed. The Mismatch Negativity (MMN) ERP component was recorded in a passive oddball paradigm using bisyllabic words with phonemic (segmental processing) and word stress contrasts (supasegmental processing in speech compehension). The NEPSY profile of the BECTS group did not deviate from the normal range, while the LKS children produced below normal scores with a weighted deficit in language and attention functions. The MMN responses elicited by phonemic contrasts were similar in the two groups, while the MMN to word-stress-pattern violations revealed a particular deficit in processing suprasegmental features in LKS. Moreover, the course of processing of stress deviants correlated with missing MMN to the lack of salient acoustic features assigned to the legally stressed syllable that is the first one as default in Hungarian. The impaired language and attention functions as compared to the relatively preserved other cognitive domains and the dissociated language process presenting already at the perceptual level points to a specific deteriorating effect existing in LKS. The temporo-parietal localization of spikes and the ESES, characteristic in LKS, and lacking in BECTS can have a crucial role in it. P118 Effects of epilepsy and valproic acid on oxidant status in children with idiopathic epilepsy 2 ¸ , S. Hız Kurul1 , F. Kuralay2 , E. Dirik1 . 1 Dokuz U. Yi¸s1 *, E. Seckin Eylul ¨ University School of Medicine Department of Pediatrics Division of Child Neurology, I˙zmir, Turkey; 2 Dokuz Eylul ¨ University School of Medicine Department of Biochemistry, I˙zmir, Turkey
The aim of this study is to evaluate the erythrocyte lipid peroxidation and antioxidant enzyme levels in patients with newly diagnosed idiopathic epilepsy before treatment and in patients treated with valproic acid for idiopathic epilepsy. Twenty-four patients with newly diagnosed idiopathic epilepsy, 24 patients treated with valproic acid for idiopathic epilepsy and 21 healthy children were included in the study.
S57 Malondialdehyde as an indicator of lipid peroxidation and antioxidants enzymes including superoxide dismutase and glutathione peroxidase were measured in the erythrocytes. The levels of malondialdehyde were significantly lower and activity of superoxide dismutase was insignificantly higher in patients with newly diagnosed epilepsy. Glutathione peroxidase levels did not differ between the groups. During treatment with valproic acid, lipid peroxidation increased but did not reach to pathological levels. There was a positive correlation between superoxide dismutase activity and duration of valproic acid treatment. In conclusion, oxidant-antioxidant status is impaired in patients with primary idiopathic epilepsy and scavenger systems are activated to decrease lipid peroxidation. Valproic acid which is frequently used in childhood epilepsy may modify the balance between oxidant and antioxidant systems. P119 Evaluation of serum lipids and carotid artery intima media thickness in epileptic children treated with valproic acid 2 ¸ , U. Yi¸s3 *, F. Demircioglu A. Erdemir1 , N. Cullu ˘ 1 , M. Kır4 , 4 ¨ , E. Dirik3 . 1 Dokuz Eylul H. Cakmak ¸ cı ¸ 2 , N. Unal ¨ University School of Medicine Department of Pediatrics, I˙zmir; 2 Dokuz Eylul ¨ University School of Medicine Department of Radiology, I˙zmir; 3 Dokuz Eylul ¨ University School of Medicine Department of Pediatrics, Division of Pediatric Neurology, I˙zmir; 4 Dokuz Eylul ¨ University School of Medicine Department of Pediatrics, Division of Pediatric Cardiology, I˙zmir
The aim of this study is to evaluate the carotid artery intima media thickness and serum lipids in pediatric patients with epilepsy treated with valproic acid. The study included 44 pediatric epileptic and 40 healthy children. Intima media thickness of left common carotid artery and fasting lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) were assessed. Although we did not observe any differences regarding serum lipid profiles, intima media thickness of common carotid artery was significantly higher in epileptic patients treated with valproic acid. We suggest that this increase in intima media thickness of common carotid artery may be due to epilepsy and/or valproic acid treatment. P120 An evaluation of patient knowledge in families with epilepsy R. Dey1 *, S. Atwal1 *, E. Wassmer1 , R. Gupta1 , B. Concannon1 . Paediatric Neurology, Birmingham Children’s Hospital, Birmingham, United Kingdom 1
Epilepsy is associated with significant morbidity and affects 1 in 280 children in the UK Inadequate patient knowledge may be associated with poor management. Therefore, improved education could have a large impact. Objective: To investigate how successfully doctors educate families with epilepsy through analysis of their knowledge. Methods: Questionnaires were administered to parents and children with epilepsy seen at Birmingham Children’s Hospital. Results: Of the 120 questionnaires posted, 59 parents and 21 children responded. In the knowledge section, 31% of parents and 96% of children demonstrated inadequate knowledge in more than 50% of the questions asked. Of the parents, 93% had a good level of knowledge in first aid (40.9% of children) and 95% knew when to seek medical help (40.9% of children), however only 27% knew their child’s syndrome type (9.1% of children) and only 50% were able to list the main side effects of medication (36.4% of children). Parents identified the following concerns at school: difficulty with classwork (72.9%), exclusion from lessons (20.0%), reduced attendance (70.9%) and bullying (32.0%). Psychosocial
Our study aimed to investigate the neurocognitive correlates of Landau Kleffner Syndrome (LKS). Six children suffering from LKS, and eight children with Benign Childhood Epilepsy with Centro-Temporal Spikes (BECTS) as clinical control have been studied. Neuropsychological assessment (NEPSY® ) providing comparable scores in five domains (language, attention and executive functions, sensorimotor function, memory and learning, visuospatial processing) as well as event-related brain potential (ERP) measures were performed. The Mismatch Negativity (MMN) ERP component was recorded in a passive oddball paradigm using bisyllabic words with phonemic (segmental processing) and word stress contrasts (supasegmental processing in speech compehension). The NEPSY profile of the BECTS group did not deviate from the normal range, while the LKS children produced below normal scores with a weighted deficit in language and attention functions. The MMN responses elicited by phonemic contrasts were similar in the two groups, while the MMN to word-stress-pattern violations revealed a particular deficit in processing suprasegmental features in LKS. Moreover, the course of processing of stress deviants correlated with missing MMN to the lack of salient acoustic features assigned to the legally stressed syllable that is the first one as default in Hungarian. The impaired language and attention functions as compared to the relatively preserved other cognitive domains and the dissociated language process presenting already at the perceptual level points to a specific deteriorating effect existing in LKS. The temporo-parietal localization of spikes and the ESES, characteristic in LKS, and lacking in BECTS can have a crucial role in it. P118 Effects of epilepsy and valproic acid on oxidant status in children with idiopathic epilepsy 2 ¸ , S. Hız Kurul1 , F. Kuralay2 , E. Dirik1 . 1 Dokuz U. Yi¸s1 *, E. Seckin Eylul ¨ University School of Medicine Department of Pediatrics Division of Child Neurology, I˙zmir, Turkey; 2 Dokuz Eylul ¨ University School of Medicine Department of Biochemistry, I˙zmir, Turkey
The aim of this study is to evaluate the erythrocyte lipid peroxidation and antioxidant enzyme levels in patients with newly diagnosed idiopathic epilepsy before treatment and in patients treated with valproic acid for idiopathic epilepsy. Twenty-four patients with newly diagnosed idiopathic epilepsy, 24 patients treated with valproic acid for idiopathic epilepsy and 21 healthy children were included in the study.
S57 Malondialdehyde as an indicator of lipid peroxidation and antioxidants enzymes including superoxide dismutase and glutathione peroxidase were measured in the erythrocytes. The levels of malondialdehyde were significantly lower and activity of superoxide dismutase was insignificantly higher in patients with newly diagnosed epilepsy. Glutathione peroxidase levels did not differ between the groups. During treatment with valproic acid, lipid peroxidation increased but did not reach to pathological levels. There was a positive correlation between superoxide dismutase activity and duration of valproic acid treatment. In conclusion, oxidant-antioxidant status is impaired in patients with primary idiopathic epilepsy and scavenger systems are activated to decrease lipid peroxidation. Valproic acid which is frequently used in childhood epilepsy may modify the balance between oxidant and antioxidant systems. P119 Evaluation of serum lipids and carotid artery intima media thickness in epileptic children treated with valproic acid 2 ¸ , U. Yi¸s3 *, F. Demircioglu A. Erdemir1 , N. Cullu ˘ 1 , M. Kır4 , 4 ¨ , E. Dirik3 . 1 Dokuz Eylul H. Cakmak ¸ cı ¸ 2 , N. Unal ¨ University School of Medicine Department of Pediatrics, I˙zmir; 2 Dokuz Eylul ¨ University School of Medicine Department of Radiology, I˙zmir; 3 Dokuz Eylul ¨ University School of Medicine Department of Pediatrics, Division of Pediatric Neurology, I˙zmir; 4 Dokuz Eylul ¨ University School of Medicine Department of Pediatrics, Division of Pediatric Cardiology, I˙zmir
The aim of this study is to evaluate the carotid artery intima media thickness and serum lipids in pediatric patients with epilepsy treated with valproic acid. The study included 44 pediatric epileptic and 40 healthy children. Intima media thickness of left common carotid artery and fasting lipid profile (total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol) were assessed. Although we did not observe any differences regarding serum lipid profiles, intima media thickness of common carotid artery was significantly higher in epileptic patients treated with valproic acid. We suggest that this increase in intima media thickness of common carotid artery may be due to epilepsy and/or valproic acid treatment. P120 An evaluation of patient knowledge in families with epilepsy R. Dey1 *, S. Atwal1 *, E. Wassmer1 , R. Gupta1 , B. Concannon1 . Paediatric Neurology, Birmingham Children’s Hospital, Birmingham, United Kingdom 1
Epilepsy is associated with significant morbidity and affects 1 in 280 children in the UK Inadequate patient knowledge may be associated with poor management. Therefore, improved education could have a large impact. Objective: To investigate how successfully doctors educate families with epilepsy through analysis of their knowledge. Methods: Questionnaires were administered to parents and children with epilepsy seen at Birmingham Children’s Hospital. Results: Of the 120 questionnaires posted, 59 parents and 21 children responded. In the knowledge section, 31% of parents and 96% of children demonstrated inadequate knowledge in more than 50% of the questions asked. Of the parents, 93% had a good level of knowledge in first aid (40.9% of children) and 95% knew when to seek medical help (40.9% of children), however only 27% knew their child’s syndrome type (9.1% of children) and only 50% were able to list the main side effects of medication (36.4% of children). Parents identified the following concerns at school: difficulty with classwork (72.9%), exclusion from lessons (20.0%), reduced attendance (70.9%) and bullying (32.0%). Psychosocial